Esophageal pH monitoring is performed if you’re having certain problems with your upper gastrointestinal tract. It helps your doctor determine if stomach acid is entering your esophagus.
The esophagus is the hollow muscular tube that connects your throat to your stomach. It’s lined with a soft mucous membrane, which protects the esophagus from damage.
The esophagus plays a very simple role in the digestive process. It conveys food from your throat to your stomach. After the mouth and teeth, this is the second portion of your upper digestive system.
It’s frequently exposed to sharp or abrasive food items, such as:
- tough plant leaves
- potato chips
You doctor may recommend this test if you have symptoms of gastroesophageal reflux disease (GERD). The test measures how often and for what length of time stomach acid enters your esophagus.
GERD is a chronic disease of the digestive system caused by the backward movement of stomach acid containing substances up from your stomach. This causes the following symptoms:
- Heartburn: acid indigestion symptoms in your stomach, esophagus, chest, or upper abdomen
- Regurgitation: acid (and sometimes food) back-flowing into your esophagus, throat, or mouth
- Dyspepsia: burping, bloating, or nausea after eating
Many people experience these symptoms from time to time. Your doctor may suspect you have GERD if you’re experiencing these symptoms more than once or twice each week.
Your doctor may also want to test you if your symptoms are so severe that they interfere with your daily life. This test may be performed in combination with an endoscopy of your upper gastrointestinal (GI) tract.
During an upper GI endoscopy, your doctor inserts a flexible fiberoptic scope with an attached camera into your esophagus, stomach, and duodenum of the small intestine to look for signs of GERD.
In infants, esophageal pH monitoring can also be used to check for stomach acid reflux issues.
You doctor will ask you to avoid eating or drinking for at least 4 to 6 hours before the test. You’ll also need to stop smoking during this time. Be sure to speak with your doctor if you need help quitting. They can refer you to local resources, such as a smoking cessation program, or suggest cessation aids.
Some prescription medications can affect the results of testing. Your doctor may tell you to stop taking them for up to 1 week or more before the test. Some drugs that can affect the test results include:
- anticholinergics (such as certain drugs used in the treatment of spastic GI tract or urine incontinence disorders)
- certain antacids
- cholinergics (drugs that produce the similar effects as the parasympathetic nervous system)
- corticosteroids (such as prednisone)
- H2 blockers (drugs used to block histamine effects on your stomach, such as Pepcid or Zantac)
- proton pump inhibitors (drugs used to reduce gastric acid production)
Only stop taking medications if your doctor advises you to do so.
Your doctor will pass a fine tube through your nostril, down your throat, and into your esophagus. A tiny pH meter is at the distal end of the tube. It measures and calculates the pH to reflect the amount of acid present.
You’ll return home with the tube in place. For the next 24 hours, you’ll keep a diary that tracks:
- what time you eat and drink
- what food you eat and drink
- what time you lie down or get up
- any related symptoms you experience
The following day, you’ll return to the hospital or office to have the tube removed. Data from the device will be combined with your notes to make a diagnosis.
Children are usually required to stay in the hospital for the entire 24 hours.
After your doctor interprets the data collected from the test, they’ll be in touch to discuss your results.
An abnormal result generally means there’s too much acid in your esophagus due to GERD. Other things that could occur alongside GERD include the following:
- scars in your esophageal lining tissue
- other causes of dysphagia (difficulty swallowing)
- Barrett’s esophagus (damaged cells in your lower esophagus due to GERD)
- reflux esophagitis (inflammation of your esophagus)
There are no significant risks related to an esophageal pH monitoring test. Rare complications include:
- inhaling vomit, if the tube causes vomiting
- an irregular heartbeat during tube insertion
Many people are able to manage the discomfort of heartburn by:
- making changes to their diet
- getting more exercise
- stopping tobacco smoking
- reducing or eliminating caffeine and alcohol consumption
- taking over-the-counter medications
If you have GERD, these solutions may offer only temporary relief. Your doctor may recommend prescription medications to control your symptoms.
Surgery may sometimes be recommended if your GERD is caused by a structural abnormality in your esophagus. The sphincter that closes the bottom of your esophagus may need to be repaired.
If you’re having symptoms of acid reflux on a regular basis, you may want to make an appointment to see your physician. They can properly diagnose and treat gastroesophageal reflux or other GI problems.